1 Lecture: Forensic Serology - Immunoassays Antibody/Antigen reaction provides the means of generating a measurable result. “Immuno” refers to an immune response that causes the body to generate antibodies. “Assay” refers to a test. An immunoassay is a test that uses immunocomplexing when antibodies and antigens are brought together.

2 Immunoassay Definitions An antibody is a protein produced in the body to a foreign substance. An antigen is the substance that the body is trying to eliminate by mounting an immune response. An analyte is anything measured by a laboratory test. Immunoassays may measure either the antigen or antibody. Immunoassays use one or more select antibodies to detect analytes of interest. Analyte may be naturally present. Analyte may be those that the body produces. Analyte may be those that does not normally occur in the body.

3 Structure of Antibodies Antibodies are a type of protein called immunoglobins. Most common protein is immunoglobin G.

4 Preparation of Polyclonal Antibodies Polyclonal antiserum is generated in animals (sheep, rabbits or goats) with the introduction of antigens into the animals bloodstream. The antiserum (serum from blood containing the desired antibodies) contains a mixture of antibodies, each of which may bind to different antigen binding sites (epitopes). Antiserum contains a mixture of antibodies. This mixture of antibodies are called ployclonal antibodies. An antigen that has multiple sites for antibody binding is called a mutivalent antigen.

5 Preparation of Monoclonal Antibodies Monoclonal antibodies are highly specific for a single epitope on a multivalent antigen. They are produced from a single cell line using hybridoma technology and mouse myeloma cell lines.

6 Categories of Immunoassay Tests Competitive Noncompetitive Homogeneous Heterogeneous Labels may be applied to either the antibody....or the antigen.

7 Competitive Assays In a competitive format, unlabeled analyte (usually the antigen) in the test sample is measured by its ability to compete with the labeled antigen in the immunoassay. In a competitive immunoassay, less label measured in the assay means more of the unlabeled (test sample) antigen is present. There are two versions of the competitive format: One step format Two step format

8 Noncompetitive Assays Noncompetitive assay formats give the highest level of sensitivity and specificity. They are normally used to measure critical analytes such as cardiac and hepatitis markers. Noncompetitive assay formats can use either one step or two step methods. In the two step assay format, there are wash steps in which the sandwich binding complex is isolated and washed to remove excess unbound labeled reagent. In noncompetitive assays, the measurement of the labeled analyte (usually the antibody) is directly proportional to the amount of antigen present in the sample.

9 Heterogeneous and Homogeneous Immunoassays Methods Immunoassays that require separation of the bound Ab-Ag* complex are referred to as being heterogeneous immunoassays. Those that do not require separation are referred to as homogeneous immunoassays. Homogeneous methods have generally been applied to the measurement of small analytes such as abused and therapeutic drugs.

10 Radioimmunoassay (RIA) Radioimmunoassay (RIA) techniques were developed in the 1960s and use radioactive isotopes as a label

11 Enzyme Immunoassay (EIA) In enzyme immunoassays (EIA), enzyme labels are used instead of radioactive labels. Typical enzyme labels include alkaline phosphatase, horseradish peroxidase and  -galatosidase. EIA tests typically use a change in color, emmission of light or other signal.

12 Enzyme Immunoassay (ELISA) Enzyme Linked Immunosorbent Assay (ELISA) is an application of solid phase heterogeneous sandwich immunoassay that combines enzyme-antibody label reagent with a solid phase bound antibody.

13 Fluorescence Polarization Immunoassay (FPIA) Fluorescence Poloarization Immunoassy (FPIA) is a type of homogeneous competitive fluoresence immunoassay. With competitive binding, antigen from the specimen and antigen- fluorescein (AgF) labeled reagent compete for binding sites on the antibody. FPIA is used to provide accurate and sensitive measurements of small toxicological analytes such as therapeutic drugs and drugs of abuse. The FPIA reagent includes the antibody reagent, a tracer, and a pretreatment detergent.

14 Fluorescence Polarization Immunoassay FPIA uses three concepts to measure specific analytes in a homogeneous format: Fluorescence Rotation of molecules in solution Polarized light

15 Fluorescence Fluorescein is a fluorescence label that absorbs light at 490 nm and releases this energy at 520 nm. Larger molecules rotate more slowly in solution that smaller molecules. Because of this, we can distinguish between the smaller antigen-fluorescein (AgF) label from antibody bound antigen-fluorescein (Ab-AgF).

16 Polarized Light When polarized light is absorbed by AgF, the molecule rotates quickly before the light is emitted as fluorescence. When the larger-sized Ab- AgF complex absorbs the polarized light, it rotates more slowly and the light is emitted in the same plane and the detector can measure it. FPIA results in an inverse response curve such that lower levels of patient analyte result in a higher signal.

17 Accuracy and Precision Accuracy means the assay is determining the correct concentration. Precision is the reproducibility of an assay. Sensitivity and specificity are subsets of accuracy and precision. An assay that has the ability to produce accurate and precise results and does not produce false positives is considered specific. An assay that has the ability to produce accurate and precise results and does not produce false negatives is said to be sensitive.

18 Calibrators and Controls Calibrators are solutions with known concentration values that establish the relationship between the signal response prodused during the assay and the analyte concentration. It is important that the user follow the manufacturer’s treatment criteria for the calibrators to ensure that the calibration is accurate. The manufacturer also has to chose the correct matrix for the calibrators has a signal response that mimics the signal from patient samples

19 Calibrators and Controls Controls are samples that contain known concentrations of analyte and are used to monitor the accuracy and precision of the assay and analyzer. If the control’s concentration is within 2 SDs of the QC average, then the assay is said to be in control and that the results collected are valid

20 Assay Interferences One step assays may be prone to interferences that affect both sensitivity and specificity. In general sequential assays are more likely to yield accurate results by elimination the adverse contribution of binding proteins, endogenous interfering substances and general matrix effects due to the extra wash step.